Fromm, “The Social Determinants of Psychoanalytic Therapy” (1935) (II)

Now, for all Freud’s interest in anxiety, particularly in his later writings, where its importance for repression is described at length, he appeared to remain uninterested in drawing its clinical implications. This indifference is certainly reflected in the “technical” papers, “Recommendations to Physicians Practicing Psycho-Analysis” (1912) and “On Beginning the Treatment” (1913) — to which Fromm critically refers in his own exposition.  It may be worthwhile, then, to recall these texts of Freud, in order better to understand and assess Fromm’s account.

In fact, Freud’s pieces are a strong indicator of Fromm’s essential “revisionism” in “Social Determinants,” even in the latter’s opening passages, which are ostensibly confined to reconstructing the “orthodox” position. Fromm writes, for instance:

“What does the intensity of the resistance depend on? According to Freud, and slightly simplified, the answer is as follows: The intensity of resistance is proportionate to the intensity of repression, and the intensity of repression in turn depends on the intensity of anxiety which itself was the cause of repression.” (150)

Yet is this really Freud’s considered position? It seems questionable. Indeed, while the “technical" papers — locus classicus of orthodox analytic technique — contain much about “repression” and “resistance,” they contain nothing at all about “anxiety” — a word that does not appear even once in its pages. In “Beginning the Treatment,” for instance, having explicated the concept of resistance and its centrality to analysis, Freud enumerates the “motive forces” that contribute to overcoming it. Among these Freud includes especially the patient’s neurotic suffering: “The primary motive force in the therapy is the patient’s suffering and the wish to be cured that arises from it” (143).

Freud implies that, once this suffering reaches a certain threshold, it may effectively surpass the distress emanating from resistance. At this point, the neurosis pain has become so unbearable that it renders the resistance pain — the pain of confronting inadmissible material — comparatively welcome. Yet according to Freud’s account here, the patient is unconsciously loathe to approach this material, not because it is anixiety-ridden, but because of the secondary gain generated by the neurosis.

Conspicuously absent from Freud’s pieces, then, is any emphasis on, or even allusion to, anxiety — let alone the analyst’s attitude as a potential “anxiety dissolvent.” This is the omission that Fromm attempts to remedy in “Social Determinants”: the “unconditional positive regard” championed later by client-centered therapy is, it seems, the analyst’s single greatest asset in diminishing the patient’s anxiety and, therefore, weakening the resistances that rest upon that anxiety.

In fact, “omission” is perhaps a misnomer here. It is not as though Freud simply “overlooked” — contingently — the potential usefulness of such an attitude in facilitating the objectives of analysis. Rather, Freud’s entire conception of ideal clinical behavior precludes such an attitude. Or, more accurately: Freud held that the “tolerance” he commended to analysts, and which he himself embodied, suffice for a “friendly, unbiased, and nonjudgmental attitude” (151). In other words, once an analyst has met certain minimal standards — displays the benign disinterest of the surgeon — he can rest assured that any outstanding “anxiety” the patient feels towards him is function of transference. The analyst’s tolerance, easy enough to achieve, makes the remaining anxiety superfluous, that is, objectively unwarranted. This “surplus” anxiety can only be explained, finally, not as an appropriate response to a threat — say, disapproval — belonging to the analytic environment, but as a belated reaction to some perceived threat in the patient’s infantile past:

“Assuming that the analyst does meet this last criterion, it looks as though the strength of the resistance is determined solely by the situation as it existed in childhood, and hardly by the present real relationship between analyst and patient. This is indeed more or less the position taken by Freud and some of his disciples. If only certain general and rather formal conditions have been fulfilled, they are inclined to regard the real personality of the analyst as rather unimportant, and to ascribe to ”transference” any reaction to the analyst—that is, to see it as a repetition of reactions originally directed at other people.” (151)

But Fromm, following Ferenczi’s example, vigorously disputes this premise. The “real” attitude of the analyst, both conscious and unconscious, is far from the natural “given” that Freud’s comments occasionally seem to indicate. Indeed, the very attitude of tolerant indifference, which Freud patterns after the surgeon’s, ultimately precludes the end at which analysis aims: the weakening of resistances and the release of repressions. Far from obviating the patient’s anxiety, this attitude inflames and justifies it. Tolerance, finally, as Freud appropriates and idealizes the value, is far from innocent of a certain moralism — particularly regarding bourgeois taboos — that the neurotic patient cannot but recognize as hostile to many of the repressed impulses analysis is meant to liberate.

“If the patient, however vaguely and instinctively, feels that the analyst takes the same condemnatory stance towards the violation of social taboos as the other persons he has met in his childhood and later on, then the original resistance will not only be transferred into the present analytic situation, but also be produced afresh. Conversely, the less judgmental an attitude the analyst takes, and the more he takes sides, in an unconditional way not to be shaken, with the happiness and well-being of the patient— the weaker the original resistance will become, and the more quickly will it be possible to advance to the repressed material” (151)

In the next entry, I will examine Fromm’s “historical” explanation of this dilemma.